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Plasenta Previa Big
Plasenta Previa Big
Pengantar
Placenta previa is an obstetric complication in which the placenta is inserted partially or wholly
in the lower uterine segment. It is a major cause of antepartum haemorrhage [1]. Placenta
previa is known to cause complications such as abnormal presentation, intrauterine growth
restriction, prematurity and fetal death. Increased rates of peripartum bleeding, disseminated
intravascular coagulation, hypovolemic shock, caesarean section operation, hysterectomy and
maternal mortality have been reported in placenta previa [2-4].
The incidence of placenta previa and complicated pregnancy varies according to the population and has
been reported as approximately 0.3%-0.8% [5-7]. While the etiology of placenta previa has not been
fully clarified, related risk factors are known to be a history of caesarean section, advanced maternal
age, multiparity, history of abortion, cigarette smoking and male gender fetus [5, 6].
Several studies have researched the risk factors for placenta previa and therefore the aim of our
study was to provide a population-based risk factor profile and thereby enable early diagnosis
plasenta previa dan oleh karena itu tujuan dari penelitian kami adalah untuk
Discussion
In literature, the prevalence of placenta previa has been reported as 0.3%-0.8% [5-7]. In recent years,
several studies have reported an increase in the prevalence of placenta previa. This increase has been
thought to be related to the enhanced trend for caesarean deliveries and the possibilities for easier
diagnosis of placenta previa by improved imaging modalities [7-9]
Diskusi
The mechanism by which advanced maternal age impairs the development of normal
blood vessels at older ages, the blood supply is impaired and compensatory
[8,11]. In some studies, the increased likelihood of placenta previa has been
masalah fetomaternal seperti persalinan prematur, pre eklamsia, diabetes melitus gestasional dan
kongenital
terjadi di pembuluh darah rahim pada usia yang lebih tua, yaitu
peningkatan paritas pada usia ibu yang lebih tua dan oleh karena itu
When parity is examined as a risk factor, atrophic endometrium changes after frequent births, short
intervals between births and multiparity have been reported to have an effect on the development of
placenta previa [5,8,11]. Tuzovic et al [9] stated the risk of placenta previa to be related to a history of 3
or more previous births and Abu Heija et al [11] stated it as 5 or more. In the current study, the risk of
placenta previa was determined to be increased In conclusion, knowledge of the predisposing obstetric
factors in respect of the development of placenta previa on a population basis, provides the possibility
of a careful approach on an individual patient basis. Careful ultrasonographic examination for the
identification of the placental location in 2nd trimester of high risk patients allows early diagnosis of
placenta previa and thereby a reduction in maternal morbidity and mortality. The limitations of our
study were the selection of patients from a single center and small sample size. In this study, the risk
factors affecting the Turkish population were found to be correlated with other ethnic-associated
studies but in respect of additional factors, there is a need for further multi-center, population-based
studies with a larger patient group.3.3-fold in those with a history of previous births compared to those
with no previous births and as the number of births increased, this was related to an increase in the risk
of placenta previa. In multiparity, just as in the age risk, the underlying pathophysiology may be infarct
and atherosclerotic changes in the uterus
Ketika paritas diperiksa sebagai faktor risiko, perubahan endometrium atrofi setelah sering
melahirkan, interval pendek antara kelahiran dan multipara telah dilaporkan memiliki efek pada
perkembangan plasenta previa [5,8,11]. Tuzovic et al [9] menyatakan risiko plasenta previa
terkait dengan riwayat 3 atau lebih kelahiran sebelumnya dan Abu Heija et al [11]
menyatakannya sebagai 5 atau lebih. Dalam studi saat ini, risiko plasenta previa ditentukan untuk
yang hati-hati pada pasien secara individu. Pemeriksaan ultrasonografi yang hati-hati untuk
identifikasi lokasi plasenta pada trimester ke-2 pasien risiko tinggi memungkinkan diagnosis dini
plasenta previa dan dengan demikian mengurangi morbiditas dan mortalitas ibu. Keterbatasan
penelitian kami adalah pemilihan pasien dari pusat tunggal dan ukuran sampel yang kecil. Dalam
studi ini, faktor risiko yang mempengaruhi populasi Turki ditemukan berkorelasi dengan studi
terkait etnis lainnya tetapi sehubungan dengan faktor tambahan, ada kebutuhan untuk studi
berbasis populasi multipusat lebih lanjut dengan kelompok pasien yang lebih besar.3.3 -lipat
pada mereka yang memiliki riwayat kelahiran sebelumnya dibandingkan dengan mereka yang
tidak pernah melahirkan sebelumnya dan karena jumlah kelahiran meningkat, hal ini terkait
dengan peningkatan risiko plasenta previa. Pada multiparitas, seperti pada risiko usia,
patofisiologi yang mendasarinya mungkin berupa infark dan perubahan aterosklerosis pada
uterus.
A previous caesarean section scar is known to cause pathological changes in endometrial and
myometrial tissue. It is thought that this scar tissue prevents the migration of the placenta to the uterine
fundus [5, 9, 11, 15]. In a study by Taylor et al [16], the placenta previa risk of women with a history of
caesarean delivery was found to be increased 1.48-fold. In another study by Getahun et al [17], it was
shown that after a first and second pregnancy had been concluded with a caesarean delivery, the risk of
placenta previa in the third pregnancy increased by 50% . In the current study, the placenta previa risk
was determined to increase 1.5-fold in those with a history of caesarean delivery, which was consistent
with literature. Uterine curettage applied after spontaneous or induced abortion forms a basis for the
development of placenta previa by damaging the uterine cavity [18-20]. In a study by Zhang et al [12],
the placenta previa risk was shown to be increased 1.6-fold in those with a history of 1 abortion, 2.3-fold
in those with a history of 2, and 3.7-fold where there was a history of 3 or more abortions. In the current
study, the risk of placenta previa was determined to increase 2.2-fold in those with a history of abortion
or uterine curettage, which was consistent with the reports in literature.
meningkat 1,48 kali lipat. Dalam studi lain oleh Getahun et al [17],
bertekad untuk meningkat 1,5 kali lipat pada mereka yang memiliki riwayat
2,3 kali lipat pada mereka yang memiliki riwayat 2, dan 3,7 kali lipat di mana
meningkat 2,2 kali lipat pada mereka yang memiliki riwayat aborsi atau
literatur.
Some studies have reported a 2.4-fold increased risk of placenta previa in patients who smoke cigarettes
[14,21- 23]. The placental growth in this situation can be explained by the vasoactive properties of
nicotine found in cigarettes and chronic hypoxia associated with carbon monoxide [22,23]. In the
current study, a strong correlation was found between cigarette smoking and the development of
placenta previa. The relationship between male gender fetus and placenta previa has been investigated
in previous studies. Although the underlying causes have not been clarified, it has been suggested that
there may be a relationship with maternal hormones or prematurity [24-26]. The findings of the current
study are consistent with those in literature. In employed women with placenta previa, there was
determined to be a 2-fold increased risk of presentation with bleeding. This could be related having less
time to rest. Although there is insufficient data related to socioeconomic factors in respect of increased
risk of placenta previa, in a study in which an increased risk of placenta previa was determined in
working women, it was suggested that this could be related to an increased rate of dilatation and
curettage in working women [27].
plasenta previa.
Hubungan antara janin berjenis kelamin laki-laki dan plasenta
dengan pendarahan. Ini bisa jadi terkait memiliki lebih sedikit waktu untuk
istirahat. Meskipun tidak ada cukup data terkait faktor sosial ekonomi sehubungan dengan